Kornimate/medical-research-clean huggingface dataset:
sleep patterns in patients affected by lymphangioleiomiomatosis

Conditions: Lymphangioleiomyomatosis; Sleep Disorder; Sleep Apnea Syndromes; Hypopnea Syndrome

Summary: lymphangioleiomyomatosis (lam) is a rare and progressive pulmonary disease of unknown etiology that almost exclusively affects women. it is characterised by cystic radiological lung pattern and by the possible presence of angiomyolipomas in other sites or organs. functionally lam is associated with airway obstruction or restriction and progressive hypoxemia up to chronic respiratory failure. there are no studies, so far, which have investigated whether during sleep these patients show changes in the sleep profile and gas exchange and if these changes are related to disease severity. aim of the study, prospective and pilot, is to evaluate whether the physiological modification of respiratory mechanics during sleep is associated with polysomnographic alterations in lam.

lymphangioleiomiomatosis (lam) is a rare progressive disease that affects primarily lungs with a cystic radiologic pattern and may be associated with angiomiolipomas in the kidneys or in other sites and an increased frequency of meningioma. patients with sporadic lam are usually female (incidence around 1/400.000 adult females). lam associated with tuberous sclerosis may affect male, female and children. lam patients are functionally characterized by obstructive or restrictive syndrome that leads patients to hypoxemia and chronic respiratory failure, so that quality of life (qol) of these patients is affected by dyspnea. hypoxemia contributes to the development of secondary pulmonary hypertension (ph) during progression of lam history, worsening the damage. the modifications in the neural control of ventilation during sleep in combination with anatomical disposition drive to sleep-related changes in upper airway resistance and physiologic desaturations. in healthy subjects these features are almost completely compensated but, in lam patients, may lead to airway obstruction and/or pathologic oxygen desaturation that could be managed. so far, none have investigated the changes in sleep architecture and related blood gas exchange in patients with lam relating these changes with disease severity. this pilot study investigate if the physiologic modifications of breathing during sleep lead to sleep disorders in lam patients, measured through abnormalities in polysomnography (psg) and ih sleep disorders in lam are associated with respiratory functional abnormalities and disease severity.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of lam according to current guidelines * sign of informed consent to participate exclusion criteria: * the presence of either acute or chronic respiratory failure * the use of long-term oxygen therapy
prebiotics and mental health: behavioural

Conditions: Emotion Regulation; Anxiety

Summary: a behavioural study of the microbiota-gut-brain axis in brain development and mental health

research suggests that modifying microbial ecology therapeutically via the intake of so-called 'psychobiotics' could help reduce stress responses and symptoms of anxiety and depression (burnet \& cowen, 2013; dinan, stanton, \& cryan, 2013; tang, reddy, \& saier, 2014). the term psychobiotics refers to both, beneficial gut bacteria (probiotics), as well as prebiotics, which enhance the growth of beneficial gut bacteria (sarkar et al., 2016). in a recent study, schmidt and colleagues explored the effects of prebiotics on the secretion of the stress hormone cortisol and emotional processing in healthy volunteers (schmidt et al., 2015). they found that cortical awakening response was significantly lower after bimunoò-galacto-oligosaccharides (bimuno) intake over 4 weeks compared with placebo. moreover, participants exhibited decreased attentional vigilance to negative information in a dot-probe task. given that anxious people show increased biases towards negative information (bar-haim, lamy, pergamin, bakermans-kranenburg, \& van, 2007), this suggests that prebiotic intake may be useful in modifying anxiety-related cognitive mechanisms. these findings will be extended to a sample of late adolescents in order to investigate how prebiotic intake for 4 weeks affects cognitive functioning, psychological well-being and gut microbiota a sample of 60 undergraduate students (aged 18-25 years). at time 1 (pre-assessment), participants in both groups will undergo comprehensive behavioural and psychological testing to establish baseline measures of cognitive functioning and psychological well-being (such as anxiety levels) and asked to collect a stool sample at home for 16s rrna sequencing of the microbiome. group 1 will then receive a daily dosage of a galactooligosaccharide (gos) prebiotic over 4 weeks, whereas group 2 will receive a placebo over the same period. at time 2 (post-assessment), both groups will again undergo cognitive and psychological testing and stool sampling. hypothesis: it is predicted that the treatment group (gos) will show improvements in behavioural indices of emotion regulation (e.g. dot probe task) and in self reported psychological measures related to emotion regulation (e.g. anxiety) in comparison to the placebo group. changes/differences in gut microbiome samples will be explored.

Eligibility criteria:
inclusion criteria: * females * aged between 18-25 exclusion criteria: * clinical levels of anxiety and/ or co-morbid diagnoses (e.g. depression) * current or previous neurological disorders * current or previous psychiatric disorders * current or previous gastrointestinal disorders * current or previous endocrine disorders * antibiotic use 3 months prior to the study * regular use of pre- and probiotics, including 3 months prior to the study * vegan diets * bmi \>30
comparison of short- and long-time action observation training on upper limb function in children with cerebral palsy

Conditions: Cerebral Palsy, Spastic

Summary: to compared short- and long-time action observation training (aot) in terms of grip strength, the jebsen taylor hand function test (jthf), the quality of upper extremities skills test (quest), and the abilhand-kids test.


Eligibility criteria:
inclusion criteria: * ages between 6 and 15 years * confirmed diagnosis of spastic cp * below grade 2 on the modified ashworth scale * between grade 4 and 8 on the house functional classification system * ability to understand the assessor's instructions. exclusion criteria: * severe spasticity in ul (mas\>2) * orthopedic surgery in the ul within 6 months * absence of sensory

Keywords: cerebral palsy
personalized mobile phone video recording to improve inhaler techniques in asthma patients.

Conditions: Asthma

Summary: to investigate the effectiveness of addition of recording video of the patient performing inhaler techniques using mobile phone for discussion with the patient, to standard care inhaler education compared to standard care inhaler education alone, in improving inhaler technique of asthma patients.

this is a single-centre, randomized, controlled, parallel group, assessor-blinded trial to evaluate the effectiveness of personalized mobile phone video recording in addition to standard care, compared to standard care alone, in improving inhaler technique among patients with asthma. patients are randomised to either personalized video recording with standard clinical practice group (intervention) or to standard clinical practice group (control) in 1:1 ratio. subject's inhaler technique assessment is performed by using a standard checklist of steps according to the type of inhaler used by subject. all inhaler technique assessment and asthma control questionnaire will be administered before the intervention/control treatment by a blinded assessor. both intervention and control treatment will be administered by the same investigators.

Eligibility criteria:
inclusion criteria: 1. 18 years old and above 2. informed consent 3. established clinical diagnosis of asthma by patient's treating doctor 4. prescribed with inhalers (any type) for therapeutic indication for at least 3 months exclusion criteria: 1. unable to converse/understand malay or english 2. not able to perform inhalation on his/her own self 3. using spacer/valved holding chamber in addition to mdi 4. not able to comply with study procedures in the opinion of investigators 5. more than two different types of inhaler which require different techniques

Keywords: inhaler technique compliance
sprint interval training in patients with chronic obstructive lung disease

Conditions: Pulmonary Disease, Chronic Obstructive

Summary: exercise therapy is a cornerstone in the management of patients with chronic obstructive pulmonary disease (copd), and supervised walking exercise three times a week over 12 weeks improves walking ability and quality of life. despite this, very few patients exercise on a regular basis. the underuse of exercise in copd patients can partly be explained by discomfort during exercise because it evokes dyspnea, and thereby explain lack of participation in exercise. if the goal is to offer the best medical therapy to these patients, new and effective exercise training methods must be explored and defined since exercise training is an important part of pulmonary rehabilitation. intention is to study a new training method called sprint interval training (sit), which consists of high intensity bouts with very short duration. the idea behind sit is to avoid the dyspnea associated with traditional endurance training, thus maximizing exercise power without excessive discomfort. the investigators will study training adaptations in patients with copd and compare the results with age-matched controls. it is expected that both copd-patients and healthy elderly will improve exercise cycle time until exhaustion after sit training, and also that the improvement will be larger in the healthy group due to higher absolute training intensity.


Eligibility criteria:
inclusion criteria (patients): * stable cpod stage 3 and 4 according to gold guidelines (www.goldcopd.org) * post bronchodilator fev \< 50% exclusion criteria: * having participated in a pulmonary rehabilitation program during the last 3 months.

Keywords: exercise therapy high-intensity interval training
feasibility study of a web-based program to help parents of middle school students effectively communicate with their children about substance use

Conditions: Substance Use; Parenting; Communication

Summary: the goal of this study is to test the feasibility of a web-based program for parents of middle school aged students. 286 parents and their child in 6th, 7th, or 8th grade will be asked to each complete two online questionnaires over the course of about a month, parents will also complete a web-based program between questionnaires. researchers will compare the intervention and an active control to test the intervention program efficacy for improving outcomes related to parent-child communication, media message processing, and adolescent health.

the purpose of this study is to evaluate and assess a self-administered, web-based program designed to increase parent knowledge about adolescent substance use, active media mediation skills, and practice high-quality parent-adolescent communication methods. the program will help parents of middle-school aged students, 6th-8th graders, communicate effectively about substance use and enhance media literacy skills to counter unhealthy media messages. prevention efforts are most impacting for adolescents in middle school years as this is the time frame for growing independence, desire to fit-in and an increase risk for their own experimentation with substances.

Eligibility criteria:
inclusion criteria: * the adult must be the legal guardian of a child in 6th, 7th or 8th grade (known hereafter as "parent"). * the parent must be able and willing to receive email and text communication as part of the study. * the parent-child pair must have access to a smartphone with internet connection as the resource review will be completed online in a format that is best viewed on a smartphone. * the parent-child pair must be fluent in english as the study materials are conducted in english. * the parent must indicate that they will give the child participant privacy to complete the questionnaires * both the adult and child must agree to participate. exclusion criteria: * in an effort to ensure diversity in parent gender and race/ethnicity, not all eligible pairs who are interested in participating will be enrolled in the study.
efficacy and safety of high dose vitamin d supplementation in patients undergoing hsct

Conditions: Hematologic Neoplasms

Summary: graft-versus-host-disease (gvhd) is common complication of hematopoietic stem cell transplantation. vitamin d deficiency has been shown to be associated with increased risk of chronic gvhd in previous clinical studies. the purpose of this research is to investigate the effect of vitamin d supplementation in patients undergoing hematopoietic stem cell transplantation

hematopoietic stem cell transplant candidates are randomized to vitamin d supplementation or usual care. five milligrams (200,000 iu) of cholecalciferol is injected to intervention group before stem cell transplantation. additional supplementation of cholecalciferol during follow-up period is determined according to the level of 25(oh)d3. the primary outcome is the incidence of chronic gvhd which is determined according to ibmtr criteria. the secondary outcome consists of the incidence of acute gvhd, incidence and severity of vitamin d deficiency, and serum concentration of 25(oh)d3. study investigators expect that supplementation of vitamin d may improve the outcome of stem cell transplantation by reducing the incidence of chronic gvhd.

Eligibility criteria:
inclusion criteria: * adults with ≥ 18 years old * diagnosed with hematologic maligancies * planned to undergo allogeneic stem cell transplantation exclusion criteria: * hypercalcemia (ionized serum calcium level \[ica\] \> 1.3 mmol/l, corrected serum calcium level \> 10.5 mg/dl) * impaired renal function (serum creatinine ≥ 2.4 mg/dl) * not in complete remssion (except for myelodysplastic syndrome and myeloproliferative neoplasm) * consent withdrawal * considered inadequate under investigator's discretion
spread and effectiveness of botulinum neurotoxin a in spastic equinus in cerebral palsy

Conditions: Cerebral Palsy and Botulinum Toxin

Summary: objectives. to study the short-term neurophysiological and clinical outcome of botulinum toxin type a(bont-a), injected at standard doses, and assess toxin spread to neighboring uninjected muscles in children with cerebral palsy. subjects and methods. the investigators studied 18 ambulatory children with dynamic equinus foot deformity (mean age 6.1 years). the gastrocnemius muscle on the affected side was injected with bont-a (dysport, range from 8.9-19.4 u/kg). as the primary neurophysiological outcome measure, compound muscle action potential (cmap) areas were assessed in the lateral gastrocnemius (lg) and tibialis anterior(ta) muscles on the treated and untreated side before bont-a injections (t0), and on days 10 (t10), and 30 (t30) after injections. clinical scales were assessed and video gait was analyzed at all three time points. results. in all patients, cmap areas recorded from the lg and ta muscles on the treated side decreased significantly from pre-injection values at t10 (p\<0.05) and t30 (p\<0.002). assessment at both time points after injections also showed that ankle spasticity had diminished (p\<0.05), equinus foot excursion increased (p\<0.05), and functional gait improved (p\<0.05). conclusion. although bont-a injected at standard doses improves gait in children with spastic equinus foot the toxin spreads to uninjected leg muscles. bont-a treatment for cerebral palsy therefore needs individualizing according to the child's clinical features.


Eligibility criteria:
inclusion criteria: * spasticity refractory to oral medication * patients able to walk independently or with aid * no contraindications to bont-a treatment such as fixed contracture,aminoglycoside therapy and myasthenia gravis and no other neuromuscular diseases * no orthopedic surgery before * normal or mildly declined cognition * previous treatment at least six months before the study exclusion criteria: * all contraindications to bont-a treatment

Keywords: bont-a-botulinum neurotoxin type a cmap-compound muscle action potential cp-cerebral palsy lg-lateral gastrocnemius mg-medial gastrocnemius ta-tibialis anterior proms-passive range of movement mas-modified ashworth scale evgs-edinburgh visual gait scale gmf-cs-gross motor function classification system
intensive interdisciplinary treatment program for individuals with stroke-induced aphasia

Conditions: Aphasia

Summary: an intensive, interdisciplinary treatment program was administered during the summer as part of regular clinic services in the aphasia resource center (arc) at sargent college. this program was run program as described for three years. not more than six native english speakers with mild or moderate profiles of aphasia and multidisciplinary rehabilitation needs (ot,pt, slp and nutrition) were recruited from the boston community to participate in an intensive interdisciplinary treatment program for four weeks during the month of june 2013. the program consists of approximately six hours of interdisciplinary treatment each day, five days per week over a four-week interval. treatment is individualized using current evidence-based treatment approaches, which are commonly accepted protocols in clinical practice and will be administered by clinical faculty and staff from speech-language and hearing sciences, occupational therapy (ot), physical therapy (pt), the center for neurorehabilitation and nutrition. segments of these types of treatments are available for a small fee as part of our service in the aphasia resource center; however, this comprehensive, interdisciplinary program is not available of this research study. approximately 30 hours of therapy per week are provided -- 6 hours per day over 5 days consisting of speech-language pathology, physical therapy, occupational therapy, and nutrition counseling.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of mild or moderate profile of aphasia secondary to a single stroke, as diagnosed by a certified speech-language pathologist. * must be able to demonstrate auditory comprehension at a level that is functional for conversation. * must demonstrate mobility or sensory deficits as a result of the stroke. * must demonstrate cardiac/nutritional needs. * must be able to ambulate without the physical assistance of another person for at least 500 feet. * must be able to negotiate elevator and stairs independently * must be able to manage bathroom needs without assistance. * must be more than twelve months post-onset of stroke. * must be between 18 and 75 years of age. * must be native speakers of english * must have 8th grade level of education or higher. * must have adequate vision for functional reading * must have adequate hearing for conversation exclusion criteria: * subjects who meet the above inclusion criteria, but who are also bilingual, and/or have concomitant neurological disease will be excluded from the study.
oral and intravenous tranexamic acid in lumbar spine surgery

Conditions: Blood Loss, Surgical; Blood Loss Anemia

Summary: the purpose of this project is to compare the effectiveness of two different but well accepted routes of administration of tranexamic acid in order to reduce blood loss and need for transfusion in patients undergoing lumbar spine surgery. specifically, this study seeks to identify if intravenous tranexamic acid is superior to oral tranexamic acid in reducing blood loss and need for transfusion.

spine surgery is associated with large amount of perioperative blood loss. factors influencing blood loss include surgical technique, operative time, number of vertebral levels arthrodesed, and others. significant blood loss is associated with complications such as hypotension, end organ damage, or coagulopathy. blood transfusions can increase risks of infection, blood incompatibility, and allergic reactions. due to the significant risks and complications associated with blood loss and allogenic transfusions, efforts to identify safe and effective ways of lowering blood loss during spine surgery are crucial. many methods have been utilized to reduce allogenic blood transfusions, such as autologous blood predonation, antifibrinolytic drugs, acute normovolemic hemodilution, intraoperative blood salvage, and others. furthermore, the administration of antifibrinolytics, such as tranexamic acid (txa) and epsilon-aminocaproic acid (eaca), has been shown to reduce bleeding in cardiac, gynecological, urologic and total joint replacement surgeries. there have been many published studies investigating various antifibrinolytic agents such as txa, eaca, and aprotinin. while aprotinin was shown to increase mortality rate in patients following cardiac surgery, txa and eaca have not been shown to cause any substantial morbidity or to increase rate of thromboembolic events. although iv txa has been shown to be effective in reducing blood loss and transfusions in patients undergoing spine surgery, no studies in the literature have investigated the efficacy of po txa in decreasing blood loss and transfusions. the investigators believe that po txa will be just as efficacious and more cost-effective in reducing blood loss and transfusion needs in patients undergoing lumbar spine surgery. the ultimate goal is identifying the most cost-effective protocol to decrease blood loss and need for transfusion. if oral txa is found to be as efficacious as iv txa in reducing blood loss and need for transfusion, significant cost savings can be achieved for the patient and the health care system in general.

Eligibility criteria:
inclusion criteria: * adult patients over age 18 and scheduled for open lumbar spine surgery (primary or revision) * must be able to swallow tablets exclusion criteria * known allergy to txa * history of renal failure or kidney transplant * history of arterial thromboembolic event (eg. myocardial infarction, stroke) within the past year * placement of an arterial stent within the past year * history of blood clots (dvt, pe) within the past year * refusal to receive blood products